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The flu season is approaching, while COVID-19 continues to be present. Markus Zeitlinger from the University Clinic for Clinical Pharmacology at MedUni Vienna recommends caution, vaccinations, and, in suspected cases, testing for SARS-CoV-2, as well as medication for people over 60 and risk groups.
The Corona vaccine continues to protect
“Similar to 2024, wastewater monitoring has already shown a fairly sharp rise in viral load this fall. Almost a third of hospital admissions for severe respiratory diseases in recent weeks were due to Covid-19,” Markus Zeitlinger told the APA.
More deaths from Covid-19 than from influenza
The official SARI dashboard clearly shows the development up to calendar week 44 with complete data, then up to calendar week 46 with mostly reported information: In calendar week 42 (mid-October), 31 percent of hospitalizations for severe respiratory diseases were due to SARS-CoV-2. Influenza accounted for just 0.2 percent, pneumococci for 0.9 percent, and RSV for 0.1 percent. With complete information available for calendar week 43, Covid-19 accounted for 27.6 percent, influenza for 0.9 percent (pneumococci: 2.3 percent). Most recently (calendar week 46; until November 16), the proportion of COVID-19 (incomplete data) was 18.7 percent, that of influenza was 2.3 percent, and pneumococci were responsible for 0.9 percent of these hospital admissions. SARS-CoV-2 far exceeded and continues to exceed influenza in terms of the “disease burden” it causes.
Caution is definitely advised. “In 2024, COVID-19 caused more deaths than influenza and is comparable to the mortality rate for breast or prostate cancer,” Zeitlinger recently explained at the Praevenire Health Days in Eisenstadt. Last year, 1,212 deaths from SARS-CoV-2 infections were recorded in Austria. Breast cancer killed 1,775 patients, and prostate cancer killed 1,434 men. The register of causes of death lists 624 victims of influenza.
Risk of severe progression and complications from Covid-19, especially for the elderly and people at risk
Practically since the beginning of the pandemic, it has been proven that Children often survive SARS-CoV-2 infection without any symptoms. Up to the age of 50, mild cases (around 80 percent) are likely. People over 60 are much more likely to experience severe cases (14 percent). Life-threatening complications are then highly possible, especially in the older age groups (five percent).
Both the recommendations for vaccination and for testing and possible drug treatment with the protease inhibitor combination nirmatrelvir/ritonavir are based on this “age pyramid” and on persons at risk. Zeitlinger quotes from the Austrian vaccination recommendations: ” The COVID-19 booster vaccination is recommended for all persons aged 12 and older who wish to reduce their risk of a potentially severe course of the disease. A single vaccination in the fall is recommended for persons with specific indications (chronic diseases, risk factors; note) as well as all persons aged 60 and older and healthcare workers.”
According to the expert, when the COVID-19 vaccine first became available, it was not known that the vaccine was not very effective at preventing SARS-CoV-2 infections. On the other hand, “the vaccine has a positive effect on the course of the disease.” Severe cases and complications can be prevented to a large extent by vaccination.
COVID-19: If in doubt, get tested – only then is treatment possible
In suspected cases, however, according to the expert, it is particularly worthwhile for the aforementioned risk groups – elderly people and people at increased risk for other medical reasons – to have a doctor test them for SARS-CoV-2 infection. Only if the infection is confirmed is it possible to treat it with nirmatrelvir/ritonavir.
Although this therapy can be started up to five days after the onset of symptoms to curb the spread of the virus, this is actually too late. Zeitlinger: “Treatment should be started as soon as possible.” Therefore, waiting when symptoms are suspected is by no means helpful. Although certain underlying conditions (kidney, liver) must be taken into account when treating COVID-19 with nirmatrelvir/ritonavir, possibly requiring dose adjustments, as must interactions with other medications, “true contraindications are rare,” said the clinical pharmacologist.
Very good data on the effectiveness of drug treatment for COVID-19 is available from Vienna’s free therapy program. According to this data, the therapy reduced the frequency of hospital admissions by about half compared to untreated patients. Mortality was also reduced. There is potentially high benefit for people at high risk of severe disease progression.
A similar study from the province of Quebec in Canada was recently published in Clinical Infectious Diseases. Nearly 15,000 people treated with nirmatrelvir/ritonavir were compared to a group of almost 300,000 people without therapy for Covid-19. In this study, Covid-19 therapy reduced the frequency of necessary hospital admissions by 74 percent, regardless of vaccination status.
- source: vienna.at/picture: pixabay.com
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